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Monday, February 13, 2012

Medical Mondays: The Squirmiest Therapy

Today, I'm going to talk about larval, or maggot therapy.

Please don't puke. Not yet, at least!

I have a pretty strong stomach but even this subject matter made me a little queasy. I had to write this post using "----" instead of maggot. By the end of writing it, I got over it. Hopefully you will too.

Maggot Debridement Therapy, or MDT, is a biotherapy that involves live, disinfected fly larvae placed in a non-healing wound or ulcer.

History
MBD has been around since ancient times. It was used by the Mayans, the Aborigine in Australia, and was noted during the Napoleonic wars and the Civil war that certain wounds covered with maggots tended to heal better and the patients died less often.

How does it work?
Apparently, the larvae exude a substance that helps to dissolve dead and dying tissues. The maggots then absorb and ingest the liquified substance and end up cleaning out the wound. The healthy tissue is, for the most part, unaffected. Some believe that MDT is even more effective at cleaning this type of wound that a surgeon could.

What about infection?
There's an automatic reaction to think that maggots are "dirty" and would cause more, not less, infection. The truth is that dead tissue is the perfect medium for bacteria to grow. By removing this medium, they actually lessen the chance of infection. Furthermore, maggots exude chemicals that kill bacteria and have a wide-range of bacteria killing activity, even against resistant bacteria like MRSA.

Er...what about the yuck factor?
Maggots can be concealed in a special covering to hide them. They will not lay eggs or multiply in the wound, as they are only larvae, not adult flies. Also, the dressings are designed to let the larvae breath and reduce the tickling sensation of them crawling all over. Er, yuck.

Is this legal?
MDT was FDA approved in 2004 as a prescription-only medical device.

What about in fictional scenarios?
Remember the movie Gladiator, with Russel Crowe? MDT was used on his shoulder wound.
In Diana Gabalson's Outlander series, there's a physician that uses MDT. Neat, huh?

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I don't think MDT is icky. I think Mother Nature is cool to provide us with such a simple solution to infections. So why isn't MDT being used more often? Is it because there's no profit in maggots? LOve that Mayans used this technique. Now that I'm living in Mexico, I LOve to learn more of the Mayan culture.

That is definitely disgusting (at least to my modern sensibilities), but really quite fascinating, to see how Nature is designed to take care of itself. Also, since I have had a fantasy story simmering for AGES involving a fictional culture based on the Mayans, this is just the sort of info that might come in handy to add a touch of realism to any after-battle scenes!

I'll ditto Laura! The first time I ever heard about this was as my dad was sharing a story from his days serving in Vietnam. He's never shared much, but he did mention a story about a fellow solder's wound and maggots. I never, ever forgot that story.

I recognize the possible benefits of MDT, but maggots totally gross me out. Can't touch 'em. Can barely look at 'em. In fact, I almost didn't read this post. And now I feel like I need to slather myself in Purell.

Ooooh Super Cool! I've never had this done but I'd be totally open to it, although, I hope I never have a wound so bad off that it needed this kind of treatment. Even though it might be icky, there's something I really love about using nature to heal things. There are times with the horses when the ONLY way to get the infection out a wound is to let the maggots do their thing. You wouldn't believe how much better the horses heal that way.

@Munk, the fly larvae are bred under sterile conditions, in the same way that medical leeches are bred under sterile conditions. And no, I'm not sure what defines 'sterile' other than the fact that the larvae are something like third generation bred in special labs and have thusly never come into contact with any outside contaminates.

Gross. But I've watched enough episodes of Bones and of House to be pretty hardcore. (Yeah, right.) This is fascinating--especially the part about maggots exuding chemicals that kill bacteria. I had no idea. (But still, yuck)

Before becoming a teacher, I worked with doctors. I've lived in group situations with doctors. I've eaten meals with doctors. I'm not easily grossed out. This post was a tricky one for me. LOL! But, I think putting it in context helped, so thank you.

Totally grossly legit, though! I'm a happy fan of maggots helping to heal. ONLY because a mommy kitty brought me one of her babies that was in distress (long story...she had crazy cat mom trust in me with several of her litters) It looked like you could see the poor babies brain through his ear, but upon vet investigation it was infested with maggots. The little guy had such a bad infection, deep in its head, the maggots saved his baby life! It was icky when they were mostly cleaned out and a few would just...plop out while he was being bottle fed, but whatever...

oh, no no no! I've actually heard of this before you wrote about it. My dad, who's from a small town in Miss., talked about a doctor using this on an old man who had like diabetes or something and his foot wouldn't heal. Crazy. But it's like nature's way, right?

I was reminded of The African Queen. Bogart is pulling the boat through a stream and then realizes he's covered in leeches. Hepburn uses something to make the leeches fall off. Bogart really sells it when he has to get back into the water to pull the boat again, knowing he'll get covered in leeches again.

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